The impact of worksite-based safety belt programs: a review of the literature.

PURPOSE The purpose of this paper is to provide a literature review of the research that examines the effectiveness of worksite intervention programs designed to increase the use of safety belts by employees. SEARCH METHODS The literature search, which identified 14 research studies on worksite safety belt programs conducted between 1968 and 1994, originated as part of a larger review on the health impact of worksite health promotion programs that was conducted by the Centers for Disease Control and Prevention (CDC). In addition, the authors conducted an additional search in an effort to validate the CDC search, but found no additional research articles. SUMMARY OF IMPORTANT FINDINGS The literature specific to the effectiveness of safety belt programs is limited to only 14 studies. The safety belt intervention most commonly evaluated used behavioral modification principles involving incentives. These and other interventions demonstrated effective increases in seat belt utilization that, upon withdrawal of the intervention, achieved a recidivism rate above baseline levels. However, the vast majority of studies failed to incorporate control groups into their research design, which caused significant threats to internal validity. Thus, a summary of findings is only suggestive at best. MAJOR CONCLUSIONS Based on the literature, there appears to be an insufficient number of quality research studies from which to derive a clear view of the impact of worksite safety belt programs. While the evidence is suggestive of a positive impact on safety belt use, there is a clear need for new, well-designed research initiatives on the effectiveness of theory-based safety belt intervention programs.